title: Renal function and cardiovascular outcomes after living donor nephrectomy in the UK: quality and safety revisited.
abstract: OBJECTIVE
  To determine renal function and cardiovascular outcomes after living donor nephrectomy (LDN). Living donor kidney transplantation has become established as the treatment of choice for end-stage renal failure. Benefits to the recipient have to be balanced against perioperative and long-term health risks to the donor.
  
  
  METHODS
  The UK Transplant Registry (UKTR) was used to identify 4586 living donors who had donated a kidney for transplantation in the UK between 2001 and 2008. This study was conducted with the consent and support of the NHS Blood and Transplant (NHSBT) Kidney and Pancreas Research Group.
  
  
  RESULTS
  The mean glomerular filtration rate (GFR) fell from 103 mL/min/1.73 m(2) before LDN to 58 mL/min/1.73 m(2) 1 year after LDN. At 1 year after LDN 60% of donors had a GFR of <60 mL/min/1.73 m(2). A GFR of <60 mL/min/1.73 m(2) after LDN was associated with older age, females, lower GFR before LDN, White ethnicity, earlier LDN period, unrelated donor type and body mass index of >25 kg/m(2). Over a 2-year period after LDN there was an overall mortality rate of 0.39%, cardiovascular death in one patient (mortality rate of 0.02%) and a major cardiovascular event rate of 0.44%.
  
  
  CONCLUSIONS
  In this study we show that mild renal dysfunction is common after LDN; however, due to the short duration of follow-up we are unable to comment on whether this subsequently leads to an increased risk of developing of cardiovascular disease.
authors.affiliation: Oxford Transplant Centre, The Churchill Hospital, Oxford, UK. nilay.patel@ouh.nhs.uk
authors.forename: Nilay
authors.initials: N
authors.lastname: Patel
authors.forename: Phil
authors.initials: P
authors.lastname: Mason
authors.forename: Sally
authors.initials: S
authors.lastname: Rushton
authors.forename: Alex
authors.initials: A
authors.lastname: Hudson
authors.forename: Rutger
authors.initials: R
authors.lastname: Ploeg
authors.forename: Peter
authors.initials: P
authors.lastname: Friend
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sinha
authors.forename: Mark
authors.initials: M
authors.lastname: Sullivan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology / Q000209:etiology*; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects*; D011446:Prospective Studies; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*; D006113:United Kingdom; D055815:Young Adult